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Internet addiction among young

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Qiaolei Jiang

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Examining Fact ors Influencing Int ernet Addict ion and Adolescent Risk Behaviors Among Exce…
Qiaolei Jiang

Online game addict ion among adolescent s: mot ivat ion and prevent ion fact ors
Ofir Turel

Int ernet Addict ion

Louis Leung, Qiaolei Jiang
 The current issue and full text archive of this journal is available at
www.emeraldinsight.com/1066-2243.htm

INTR
24,1
Internet addiction among young
people in China
Internet connectedness, online gaming,
2 and academic performance decrement
Received 5 January 2013 Qiaolei Jiang
Revised 26 February 2013 School of Humanities and Social Sciences, Dalian University of Technology,
30 March 2013 Ganjingzi District, Dalian City, Liaoning Province, China
Accepted 30 March 2013

Abstract
Purpose – The purpose of this paper is to investigate the interrelationships between internet
connectedness, online gaming, internet addiction symptoms, and academic performance decrement
among the internet-dependent young people in China.
Design/methodology/approach – A paper-based survey was conducted among the young clients
in one of the earliest and largest internet addiction clinics in China. A total of 594 in-patients (mean
age ¼ 17.76 y) voluntarily participated in this study.
Findings – By adopting the concept of internet connectedness, this study explored the internet use
patterns among the young internet addicts, for example, internet café patrons and those who use
internet with more goals or higher degree of internet adhesiveness had more internet addiction
symptoms. Online gaming was found to play a significant role in the development of internet
addiction. As expected, the level of internet addiction is significantly linked to academic performance
decrement. Consistent with previous studies, males showed higher degree of internet connectedness
and online game usage than females. Noticeably, the moderation effect of online game playing and
the mediating effect of internet addiction were also tested.
Research limitations/implications – This research is focussed on the internet-dependent group,
thus the generalizability of the results need to be interpreted with caution.
Practical implications – This study provides insight for parents, educators, health professionals,
and policy makers regarding treatment and intervention for internet addiction among young people in
China.
Originality/value – Since very little research has been done focussing on diagnosed internet-dependent
group, this paper scores as a pioneering study of its kind in China.
Keywords China, Young people, Academic performance, Internet addiction, Internet connectedness,
Online game
Paper type Research paper

Introduction
In about ten years, internet addiction has undergone a remarkable metamorphosis in
China, from a psychiatric curiosity to a publicly recognized health risk, especially
among young people. The internet users under 30 now account for 58.2 percent of the
total Netizen population (CNNIC, 2012), thus young people have become the main body
of the Chinese internet users (Huang et al., 2009). According to the latest version of
research report on internet addiction conducted by China Youth Internet Association,
14.1 percent of the adolescent internet users in urban China are suffering from internet
addiction, which is about 24 million of them (China Youth Internet Association (CYIA),
Internet Research
Vol. 24 No. 1, 2014
2010, p. 7). The rate in rural area is close to this one, therefore the total approximated
pp. 2-20 figure can reach 33 million, almost twice as many as the number in 2005 (CYIA, 2010).
r Emerald Group Publishing Limited
1066-2243
There are also about 18.6 million adolescent internet users in urban China show their
DOI 10.1108/IntR-01-2013-0004 tendency toward internet addiction (CYIA, 2010, p. 8). China is now struggling with
this new plight. It is estimated that approximately 11 percent of the Chinese internet Internet
users have internet dependence (CNNIC, 2009, p. 41), and 27.1 percent of the adolescent addiction
internet users in China have an inclination to internet addiction, to the detriment of
work, study, and social life (CNNIC, 2008).
Therefore, the Chinese Government tries to regulate the internet and peoples’
internet use in different ways. For example, no internet cafés or game labs are allowed
to operate within 200 meters around schools, strict licensing procedures, control of the 3
business hours, restrictions of minors’ entry into internet cafés, and installation of
the anti-addiction software (Tao, 2007). The effectiveness of such moves is debatable,
but they undoubtedly enable legislators to show that they are doing something about
this seemingly intractable social problem (Buckingham, 2002). Internet addiction as
an issue has been included in the Law of the People’s Republic of China on the
Protection of Minors in 2007 (Tao, 2007). Currently, more and more research projects,
therapeutic clinics, psychiatric counseling centers, and self-help groups have
mushroomed in urban China ( Jiang and Leung, 2012).
However, neither in China nor in other social contexts, research focussed on the
internet-dependent users remains rather sparse. Previous studies on internet addiction
mainly used high school and university student samples, in both China and western
societies (Byun et al., 2009; Huang et al., 2009). Thus, the purpose of this study is
to fill the gap by examining the internet-dependent group, specifically among young
people. Based on an in-depth review of relevant studies, this study aims to evaluate
the internet use of the internet-dependent respondents and investigate the
interrelationships among internet addiction, internet connectedness, online gaming,
and academic performance decrement.

Literature review
Internet addiction
Previous research has alleged that excessive internet use can be pathological and
addictive, which is treated as internet addiction disorder (IAD) in clinical settings
(Furnell and Warren, 1997; Kingsley and Anderson, 1998; Mafé and Blas, 2006;
Widyanto and Griffiths, 2006). Past studies on internet addiction revealed numerous
symptoms shared by other forms of addiction, including substance-based addictions,
such as tolerance, withdrawal, preoccupation, numerous unsuccessful attempts to cut
down use of the internet, and feeling restless without internet (Huang et al., 2009;
Widyanto and Griffiths, 2006).
Scholars have developed various scales to study IAD symptoms, such as Morahan-
Martin and Schumacher’s (2000) 13-question scale, Scherer’s (1997) ten-item checklist
of IAD symptoms, Young’s (1998a) eight-item questionnaire, and Chinese Internet
Addiction Scale by Chen and Chou (1999). Generally, Young’s (1998a) classical
eight-item Internet Addiction Diagnostic Questionnaire (DQ), which was modified
from DSM-IV (Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition)
criteria for pathological gambling, is widely used to examine IAD symptoms. Young’s
(1998a) DQ is a set of eight questions related to the individual’s preoccupation with the
internet, amount of time spent online, and effects of the internet in one’s life (Chou et al.,
2005). In this study, IAD symptoms were measured based on Young’s (1998a) DQ.

Internet connectedness
In order to investigate internet addiction, specific instrument is needed to measure
an individual’s overall internet use pattern. Based on media system dependency theory,
INTR internet connectedness was developed to capture a person’s overall relationship with
24,1 the internet ( Jung et al., 2001; Loges and Jung, 2001). Facing the limitations of
conventional binary measure (access/non-access) or a time-based measure (number
of hours spent on the internet), Jung et al. (2001) developed the multi-dimensional
concept of internet connectedness index (ICI), which incorporates conventional
measures such as time, history, and context, and also goes beyond to capture scope,
4 intensity, and centrality of internet in one’s life.
The ICI is composed of nine factors, which are internet use history, task scope,
site scope, goal scope, activity scope, time scope, evaluation of the internet, internet
dependency, and computer dependency. Specifically, internet use history was
operationalized as the number of years a person has used the internet. Task scope
referred to the number of tasks for a person to use internet. Site scope concerned
the places where a person connects to the internet, such as home, internet café, school,
a community center, or a public library. Goal scope adopted the six media-system
dependency goals by Ball-Rokeach (1985, 1998), including two understanding goals
(social understanding and self-understanding), two orientation goals (action
orientation and interaction-orientation), solitary play, and social play. Activity scope
was about the online activities people participating in, such as bulletin boards (BBS),
chat rooms, weblog, game playing, social network sites (SNS), video/audio viewing/
downloading, research/information, shopping, and surfing the web. Time scope
indicated the intensity of internet use. Evaluation indicates how the internet affects
individuals’ personal life. Internet dependency was measured by asking “Imagine
that you woke up tomorrow to find that the Internet had vanished, how much would
you miss being able to use the Internet, using the 10-point scale where 1 means you
wouldn’t miss it at all and 10 means you would miss it an extreme amount?” Computer
dependency was measured by asking similar question above, but instead awaking to
find that computer had vanished. The modified version of ICI includes some updated
items, such as broadband access and 3G mobile internet access (Leung, 2010).
As a measure with multiple items, ICI may capture more aspects of people’s
internet use ( Jung et al., 2001; Leung, 2010; Loges and Jung, 2001). Moreover, ICI should
have a greater likelihood than the conventional single-item measures of producing
significant outcomes, simply on statistical grounds. Therefore, it is reasonable to
predict the following:

H1. Those with higher degree of ICI tend to show more IAD symptoms.

Online gaming
As Young (1998b) stated, the internet itself is not addictive. Dependents are less
likely to control their use of highly interactive features than other online applications
(Toral et al., 2009; Young and Rodgers, 1998; Zhou, 2011). Prior research has
speculated that specific applications, especially those entertainment applications with
immersive or interactive features, appeared to play a significant role in the
development of pathological internet use, and pose great threat to the well-being of the
users (Kim et al., 2009; Wan and Chiou, 2006). In particular, online games are such
entertainment applications online (Chen et al., 2005; Huang and Hsieh, 2011; Lu and
Wang, 2008).
Many recent games domain is the networked three-dimensional fantasy-themed
first-person-view games with clear gaming narratives, where gamers are represented
as versatile avatars who can walk, talk, take part in hunting, combat or various Internet
economic activities, and may also make friends, form communities, and fall in love addiction
which all offer a sense of belonging (Chuang, 2006; Whang and Chang, 2004).
Certain specific aspects of online games appear to facilitate excessive play to a high
extent, such as role-playing, immersion, competition, interaction, realistic scenarios,
and various in-game tasks (Hussain and Griffiths, 2009). Nowadays, online games are
more intensive, more complex, more graphic, more violent, and more bloodthirsty 5
than those earlier computerized games, and also with a larger and more thriving
social network (Chuang, 2006).
Online gaming can be extremely engaging and time-consuming and some gamers
invest so much time and effort that they even neglect eating, sleep, hygiene, exercise,
school, and work in order to stay longer in the pleasant, satisfying, and persistent
virtual worlds (Hsu and Yu, 2007; Hussain and Griffiths, 2009). Given the amount of
time young people spend playing online games, and their liking for the games,
questions are raised whether online games have a deleterious impact on youth, and
whether playing online games can lead to internet addiction. In massive news
coverage, Chinese media metaphorically frame online games as internet opium or
electronic heroin, especially for young people who are more vulnerable (Jiang and
Leung, 2012). Previous studies found that many players appeared to display the core
components of addiction, such as salience, mood modification, tolerance, craving,
conflict, withdrawal symptoms, and relapse (Grüsser et al., 2007; Hussain and
Griffiths, 2009). Thus, online gaming has become one of the most addictive activities
on the internet, and some scholars even proposed it as one subtype of internet
addiction (Wan and Chiou, 2006; Young, 1998b). According to CYIA (2010), 47.9 percent
of the adolescent internet addicts suffer online game addiction, who spend most of
the time online playing games. Thus, this study aims to investigate the relationship
between online gaming, internet connectedness, and internet addiction. The following
hypotheses are proposed:

H2. Online game players tend to show (a) higher degree of ICI and (b) more IAD
symptoms than non-players.

H3. Online game players who have more online game usage tend to show (a) higher
degree of ICI and (b) more IAD symptoms.

Additionally, this study tries to test its moderating effect:

RQ1. How can online game playing moderate the relationship between ICI and
IAD symptoms?

Previous studies also show that males are more delinquent in internet use than females
(Huang et al., 2009; Ma et al., 2011). Online games are usually more popular among
males, because of their graphic, emotional, and mainly violent nature (Carnagey and
Anderson, 2005; Grüsser et al., 2007). In China, internet cafés have become masculine
gaming spaces full of males playing various online games (Hsu and Chuang, 2008).
Hence, the following hypothesis is proposed:

H4. Males tend to have (a) higher degree of ICI and (b) more online game usage than
females.
INTR Academic performance
24,1 Many studies have been conducted to examine how academic performance is related to
young people’s internet use. Previous studies find that the internet has produced mixed
results ( Jackson et al., 2007; Roschelle et al., 2000). On one hand, some studies suggest
that the internet provides tremendous educational benefits, such as more information
access, better visual intelligence skills, and enhancement of teacher-student communication
6 (Ni et al., 2009; Subrahmanyam et al., 2000, 2001).
On the other hand, many negative impacts are listed, such as most non-school hours
are spent on the internet or playing online games, not keeping up with assignments,
missing classes, falling asleep in school, declining grades, failing a course, missing
a social engagement, and dropping out of other social groups (clubs or sports) (Huang
et al., 2009; Kim et al., 2009; Orzack, 2003). Research on the relationship between
internet use and the ability to focus attention showed that amount of time spent
using the internet by young people was significantly related to higher ratings of
distractibility for academic tasks (Levine et al., 2007). Excessive internet use also
caused deficient self-regulation (LaRose et al., 2003), and poor performance at school
(Clark et al., 2004). According to their findings, Chou and Hsiao (2000) report that
Taiwanese students might develop some academic problems, such as dropping out
or losing learning interest in school, owing to excessive use of the internet.
Previous studies have investigated the relationship between online gaming
engagement and academic achievement among adolescents and university students,
and the results show that the addicted players had lower school grades than their
non-addicted peers (Leung and Lee, 2012). Therefore, the present study attempts to
investigate the addictive potential of online gaming as well as the possible deleterious
effect on young people’s school performance. As a result, the following hypothesis and
research questions are proposed:

H5. Those who show (a) more IAD symptoms, (b) higher degree of ICI, or (c) more
online game usage, tend to have more academic performance decrement.

RQ2. How can online game playing moderate the relationship between ICI and
academic performance decrement?

RQ3. How can IAD symptoms mediate the relationship between online gaming
and academic performance decrement?

RQ4. How do internet connectedness, online gaming, and demographics predict

IAD symptoms?

RQ5. How do internet connectedness, online gaming, IAD symptoms, and demographics
predict academic performance decrement?

Methods
Participants
The data were collected in one of the earliest and largest internet addiction clinics
in Mainland China, the Chinese Youth Psychological Development Base (hereafter
referred to as “the Base”). Opened in 2005, the Base is in the southern suburb of Beijing,
and is affiliated to the Addiction Medicine Center in the General Hospital of Beijing
Military Region. All the clients are required to go through the diagnostic interview on Internet
admission to diagnose internet addiction. addiction
According to the definition from World Health Organization, young people are those
individuals aged ten to 24 years old, including two overlapping age groups,
adolescents (ten to 19), and youth (15-24) (WHO, 2012). Therefore, this study is focussed
on the diagnosed internet addicts aged ten to 24. A paper-based survey was conducted
among the young clients after the diagnostic interview, with the consent obtained 7
from both the clients and their parents, because most of these young clients entered the
Base with their parents. With the assistance of the Base administration office, 594 in-
patients voluntarily participated in this study. All the 594 respondents were diagnosed
with IAD in the diagnostic interview on admission. For the inter-rater reliability of
the diagnosis, the consistency rate of any two psychiatrists reached 98.0 percent.

Measures
The data were divided into five parts: internet connectedness, online gaming, IAD
symptoms, academic performance decrement, and demographics.
Internet connectedness. As aforementioned, the measurement of internet
connectedness was composed of nine domains. First, internet use history was measured
as the number of years the respondents had used the internet on a four-point scale,
from “less than one year” to “more than five years.” Second, task scope referred to
the number of tasks to use internet. The respondents were asked whether they used
internet for work-related, school-related, or personal-related tasks, with 1 ¼ “yes” and
0 ¼ “no.” Responses were added up to show the breadth of tasks. Third, referring to site
scope, the respondents were asked whether they went to internet café to use internet.
Fourth, goal scope adopted the six media-system dependency goals raised by Ball-
Rokeach (1985, 1998): to stay on top of events and groups that you care about; to
express yourself or your opinions; to accomplish business, financial, or work tasks;
to get advice on how to deal with other people, such as doctors and other health
professionals; to play or amuse yourself; and for social reasons like making new
friends. The respondents were asked how many of the six goals they pursue through
online activities. The original responses (0-6) were re-coded as 1 referring to none of
the goals being chosen and 2 for choosing one or more goals. Fifth, activity scope was
measured by asking the respondents “What Internet activities do you participate in,
other than e-mail?” Response categories included chat rooms, game playing, video/
audio viewing/downloading, shopping, research/information, BBS, weblog, SNS, and
surfing the web. The total number of responses (0-9) indicates breadth of participation,
and then 0 was re-coded as 1, and others were re-coded as 2. Sixth, intensity scope was
about the time spent on interactive online activities. The respondents were asked
“Not counting personal e-mail, how many hours do you spend on participating in any
online activities interacting with other people (such as chat rooms and game-playing)?”
Those who did not participate in the interactive online activities were coded as 1, and
the others were coded as 2. Seventh, evaluation of how the internet affects personal life
was assessed by the question, “Thinking about all the pros and cons of the Internet,
would you say it has an overall positive or negative effect on your life?” on a five-point
Likert scale, and recoded as 1 (very negative and somewhat negative), 2 (neutral), to 3
(somewhat positive and very positive). Eighth, internet adhesiveness was measured by
asking “How many hours did you spent online continuously as for the longest time?”
Responses were re-coded as 1 (less than six hours), 2 (six to 18 hours), 3 (19-24 hours),
and 4 (more than 24 hours). Finally, computer interest was measured by asking
INTR the respondents whether they were interested in computer or not. Each domain was
24,1 multiplied by a value to create a common factor of 12, for instance, internet use history,
a four-point scale, was multiplied by three, while binary scales, such as site scope,
goal scope, activity scope, and intensity scope were multiplied by six, respectively.
ICI was calculated by taking an overall average, ranging from 1 to 12. The reliability
a was 0.76 for this subscale.
8 Online gaming. This subscale was composed of three items, including frequent
online game playing, online gaming history, and number of friends online. Specifically,
the respondents were asked to give dichotomized responses (yes or no) on whether
they are frequent online game players; they were asked to indicate on a four-point scale
(from “before six years old” to “after 18 years old”) on when they began playing online
games; and the respondents also responded on a five-point Likert scale (from “none” to
“quite a lot”) on the number of friends online. To create an online gaming index, each
item was multiplied by a value to create a common factor of 20. Online gaming index
was calculated by taking an overall average, ranging from 1 to 20. The reliability a was
0.70 for this three-item subscale.
IAD symptoms. According to Young’s (1998a, b) classic eight-item symptom checklist
for internet addiction, the respondents responded yes or no on whether they agreed on
the following statements: “Do you feel preoccupied with the Internet (think about
previous on-line activity or anticipate next on-line session)?”; “Do you feel the need to use
the Internet with increasing amounts of time in order to achieve satisfaction?”; “Have you
repeatedly made unsuccessful efforts to control, cut back, or stop Internet use?”; “Do you
feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet
use?”; “Do you stay on-line longer than originally intended?”; “Have you jeopardized or
risked the loss of significant relationship, job, educational or career opportunity because
of the Internet?”; “Have you lied to family members, therapist, or others to conceal the
extent of involvement with the Internet?”; and “Do you use the Internet as a way of
escaping from problems or of relieving a dysphoric mood (e.g. feelings of helplessness,
guilt, anxiety, depression)?” The reliability a was 0.86 for this scale.
Academic performance decrement. To assess respondents’ academic impairment
due to their internet use, a scale was adapted from previous studies (Huang and Leung,
2009; Kubey et al., 2001). The subscale contained three items on a five-point Likert
scale, ranging from 1, never, to 5, always: How often has your schoolwork been hurt
because of the time you spend online? (How often did you sleep late because of using
internet? How often did you feel too tired to go to school the next day because you spent
too much time online the previous night? The reliability a was 0.73 for this subscale.
Demographics. The demographic characteristics of the respondents, including
gender, age, education levels, and occupation background were also collected.

Sample profile
Of the 594 participants, 91.4 percent were male. The mean age was 17.76. Among them,
27.1 percent were at school, 33.0 percent were school dropouts, 29.0 percent suspended
their schooling, 1.6 percent at work, and 9.3 percent were unemployed. Participants
were from almost all the 34 provincial regions, except Tibet and Macau.

Results
To answer the proposed research questions and to test the hypotheses, relevant
analyses procedures were conducted correspondingly. The results are presented
as follows.
Correlations between IAD symptoms, ICI, online gaming, and academic performance Internet
decrement addiction
To test the first, third, and fifth hypotheses, correlations were performed to examine
possible relationships among IAD symptoms, ICI, online gaming, and academic
performance decrement. Results in Table I showed that IAD symptoms was significantly
and positively correlated with ICI, online gaming, and academic performance decrement,
r (583) ¼ 0.23, po0.01, r (570) ¼ 0.35, po0.001, and r (569) ¼ 0.42, po0.001, respectively. 9
ICI was found to be significantly and positively correlated with online gaming,
r (575) ¼ 0.20, po0.01. Online gaming was found to be significantly and positively
correlated with academic decrement, r (578) ¼ 0.21, po0.01. However, no correlations
were found between ICI and academic performance decrement, and r (584) ¼ 0.16, ns.
Therefore, all hypotheses except H5(b) were supported. Accordingly, the
respondents with higher degree of internet connectedness tended to show more IAD
symptoms. As one of the most popular internet activities, more online gaming led to
higher degree of internet connectedness and even internet addiction, as well as more
academic performance decrement. More IAD symptoms also led to more academic
performance decrement. However, those respondents with higher degree of internet
connectedness might not necessarily have more academic performance decrement.
Thus, the interrelationship might be more complicated than a simple correlation.
Summary of the correlation results among IAD symptoms, ICI, online gaming,
and academic performance decrement is presented in Table I.

Differences in IAD symptoms and ICI between online game players and non-players
t-tests were performed to examine possible difference between online game players
and non-players. Significant differences were found in IAD symptoms and ICI. The
means for online game players and non-players in IAD symptoms were M ¼ 6.14
(SD ¼ 1.07) and M ¼ 4.56 (SD ¼ 1.46), respectively, t(585) ¼ 10.48, po0.001. The means
for online game players and non-players in ICI were M ¼ 11.40 (SD ¼ 3.51) and
M ¼ 10.62 (SD ¼ 3.60), respectively, t(576) ¼ 2.01, po0.05. Thus, the second hypothesis
was supported. More online gaming led to more IAD symptoms and higher degree of
internet connectedness. The descriptive data for online game players and non-players
are presented in Table II.

2 3 4
Table I.
1. IAD symptoms (composite) 0.23** 0.35*** 0.42***
Zero-order Pearson’s
2. ICI 0.20** 0.16
correlations among IAD
3. Online gaming 0.21**
symptoms, ICI, online
4. Academic performance decrement
gaming, and academic
Notes: N ¼ 594. **po0.01; ***po0.001 performance decrement

Online game players Non-players

Variable M SD M SD t Table II.
Means and standard
a. IAD symptoms 6.14 1.07 4.56 1.46 10.48*** deviation of IAD
b. ICI 11.40 3.51 10.62 3.60 2.01* symptoms and
ICI for online game
Notes: N ¼ 594. *po0.05; ***po0.001 players and non-players
INTR Gender differences in ICI and online gaming
24,1 To test the fourth hypothesis, t-tests were performed to examine possible gender
difference in internet use variables (see Table III). Significant gender differences were
found in both ICI and online gaming. The means for males and females in ICI were
M ¼ 8.25 (SD ¼ 3.27) and M ¼ 6.99 (SD ¼ 3.45), respectively, t(591) ¼ 2.24, po0.05. The
means for males and females in online gaming were M ¼ 13.65 (SD ¼ 9.56) and
10 M ¼ 6.21 (SD ¼ 9.38), respectively, t(576) ¼ 4.81, po0.001. Therefore, consistent with
the reviewed literature, males showed higher degree of internet connectedness and
online game usage than females.
The results for the female and male respondents are presented in Table III.

Moderator function of online gaming between ICI and IAD symptoms

To test the moderator function (see Figure 1) of online game playing between ICI and
IAD symptoms proposed in the first research question, analysis of variance (ANOVA)
was conducted based on the procedures outlined in previous literature (Baron and
Kenny, 1986).
ICI ranging from 1 to 12 was dummy-coded into high and low groups with the
median 7 as the cutoff point, and 2  2 factorial design was adopted. The results in
Table IV show the main effects from ICI, F(1, 593) ¼ 4.01, po0.05, and from online
game playing, F(1, 593) ¼ 15.43, po0.001, as well as the interaction effect of the

Male (n ¼ 543) Female (n ¼ 51)

Variable M SD M SD t
Table III.
Means and standard ICI 8.25 3.27 6.99 3.45 2.24*
deviation of internet use Online gaming 13.65 9.56 6.21 9.38 4.81***
variables for male and
female respondents Notes: N ¼ 594. *po0.05; ***po0.001

ICI
(Predictor)

Online game playing IAD symptoms

(Moderator) b (Outcome variable)
c

ICI
(Predictor)
X
Online game playing
(Moderator)

Figure 1.
Moderator model
Note: Moderator function of online gaming between ICI and IAD symptoms
two variables. A pattern emerged such that association between ICI and IAD Internet
symptoms was moderated by online game playing. The results show that the online addiction
game player group reported more IAD symptoms than the non-player group. Within
the non-player group, higher degree of ICI led to more IAD symptoms. However, the
influence of online gaming is so strong that ICI did not have much
effect within the online game player group. Plots of these interactions are
presented in Figure 2. 11
Moderator function of online gaming between ICI and academic performance decrement
To test the possible moderator function (see Figure 3) of online game playing between
ICI and academic performance decrement, another ANOVA was conducted. ICI was
dummy-coded into high and low groups and 2  2 factorial design was adopted.
The results in Table V show no main effects from ICI, F(1, 0593) ¼ 0.711, ns, or from
online game playing, F(1, 593) ¼ 0.220, ns, and no interaction effect of the two variables
as well. Consistent with the findings regarding H5(b), the interrelationship between
ICI and academic performance decrement turned out to be more complicated
than a simple correlation or a single moderator function.

Online game playing No online game playing

N M SD N M SD
Low ICI 213 5.91 1.05 142 4.38 1.35
High ICI 54 5.85 1.06 20 5.43 0.53
IAD symptoms Table IV.
Source of variance Sum-of-squares df Mean square F p Means and ANOVA for
ICI 4.967 1 4.967 4.013 0.046 the effects of ICI and
Online game playing 19.095 1 19.095 15.425 0.000 online game playing on
ICI  online game playing 6.163 1 6.163 4.963 0.027 IAD symptoms

Online game
6 playing
No online game
5 playing
IAD symptoms

Figure 2.
1 Moderation effect of
online gaming between
0 ICI and IAD symptoms
Low ICI High
INTR ICI
24,1 (Predictor)

Academic performance
Online game playing
decrement
12 (Moderator) b
(Outcome variable)

c
ICI
(Predictor)
X
Online game playing
(Moderator)

Figure 3.
Moderator model Notes: Moderator function of online gaming between ICI and academic
performance decrement

Online game playing No online game playing

N M SD N M SD
Low ICI 203 2.03 0.83 67 1.87 0.94
Table V. High ICI 26 1.93 0.77 10 2.25 0.79
Means and ANOVA for Academic performance decrement
the effects of ICI and Source of variance Sum-of-squares df Mean square F p
online game playing on ICI 0.513 1 0.513 0.711 0.400
academic performance Online game playing 0.158 1 0.158 0.220 0.640
decrement ICI  online game playing 1.433 1 1.433 1.986 0.160

Mediating effect of IAD symptoms between online gaming and academic performance
decrement
To test the mediating effect (see Figure 4) of IAD symptoms between online gaming
and academic performance decrement proposed in the second research question,
a series of regression analyses were conducted based on the procedures outlined by
Baron and Kenny (1986). As shown in Table VI, in the first equation, online gaming

IAD symptoms
(Mediator)
a

Online gaming Academic performance

(Independent c decrement
variable) (Outcome variable)

Figure 4.
Mediator model Note: Mediating effect of IAD symptoms between online gaming and
academic performance decrement
Eq. Step Variables entered B SE b t DR2 Total R2
Internet
addiction
Regressing the
mediator on the independent variable
a. 1 Online gaming 0.19 0.03 0.35 7.20*** 0.12 0.12
Regressing the
dependent variable on the mediator
b. 1 IAD 0.25 0.03 0.40 9.00*** 0.16 0.16
Regressing the
dependent variable on the independent variable 13
c. 1 Online gaming 0.06 0.02 0.17 3.46** 0.03 0.03
Regressing the
dependent variable on both the independent variable and on the mediator
d1. 1 Online gaming 0.06 0.02 0.17 3.46** 0.03 0.03
2 Online gaming 0.02 0.02 0.06 1.12 0.14 0.17
IAD 0.25 0.03 0.39 7.62***
d2. 1 IAD 0.25 0.03 0.40 9.00*** 0.16 0.16 Table VI.
2 IAD 0.25 0.03 0.39 7.62*** 0.01 0.17 Hierarchical regression
Online gaming 0.02 0.02 0.06 1.12 equations predicting
academic performance
Notes: N ¼ 594. **po0.01; ***po0.001 decrement

as the independent variable significantly affected the presumed mediator (i.e. path “a”
in Figure 4). Moreover, variations in IAD symptoms as the mediator significantly
accounted for variations in academic performance decrement as the dependent
variable (i.e. path “b” in Figure 4) in the second equation. Furthermore, the independent
variable significantly affected the dependent variable in the third equation. However,
the previously significant relation between online gaming (the independent variable)
and academic performance decrement (the dependent variable) was no longer significant
when the mediator (IAD symptoms) was entered, which indicated strong evidence for
mediating effect (Baron and Kenny, 1986). Sobel’s test revealed that Z ¼ 5.62, po0.001.
Therefore, all the conditions for meditational model were met. IAD was the mediator
between online gaming and academic performance decrement, so online gaming
might not necessarily lead to academic performance decrement, but those who played
online games to certain degree of showing IAD symptoms would have a lot of academic
performance decrement. Accordingly, the results are presented in Table VI.

Predicting IAD symptoms

To examine the relative influence of demographics, internet connectedness and online
gaming on IAD symptoms as proposed in RQ3, a hierarchical regression was run.
The results in Table VII indicate that the respondents who reported more IAD symptoms
tended to be those who could not maintain normal social status at an average age of
being a young person (b ¼ 0.13, po0.05). This means that those respondents who
were school dropouts, suspended students, or unemployed had more IAD symptoms.
As the first block of predictors, demographics explained 3 percent of the variance. When
variables from internet connectedness entered into the equation in the second block,
site scope (b ¼ 0.14, po0.01), goal scope (b ¼ 0.16, po0.001), and internet adhesiveness
(b ¼ 0.10, po0.05) were found to be significant predictors. This indicates that the internet
café users who use internet with more goals and higher degree of internet adhesiveness
had more IAD symptoms. The IC block explained 11 percent of the variance. Finally,
online gaming is the third block, and the results show that frequent online game playing
(b ¼ 0.47, po0.001) was the strongest predictor for IAD symptoms. As the last block of
predictors, online gaming explained most of the variance at 12 percent. The hierarchical
regression explained 26 percent of the variance in total.
INTR
Predictors IAD symptoms, b DR2
24,1
Block 1: demographics
Gender (male ¼ 1) 0.00
Age 0.06
Education level 0.02
14 Social status (normal ¼ 1)a 0.13* 0.03
Block 2: internet connectedness
History scope 0.00
Task scope 0.01
Site scope (internet café ¼ 1) 0.14**
Goal scope 0.16***
Activity scope 0.03
Intensity scope 0.06
Evaluation 0.02
Internet adhesiveness 0.10*
Computer interest 0.07 0.11
Block 3: online gaming
Frequent online game playing (yes ¼ 1) 0.47***
Time gaming history 0.02
Table VII. Number of friends online 0.09 0.12
Hierarchical regression R2 0.30
analysis of the impact of Adjusted R2 0.26
demographics, internet
a
connectedness, and online Notes: N ¼ 594. normal (at school or at work) ¼ 1, not normal (school dropout, suspending, and
gaming on IAD symptoms unemployed) ¼ 0; *po0.05; **po0.01; ***po0.001

Predicting academic performance decrement

To examine the relative influence of demographics, internet connectedness, online
gaming, and IAD symptoms on academic performance decrement as proposed in RQ4,
a hierarchical regression analyses were run.
The results in Table VIII indicate that the respondents who reported more
academic performance decrement tended to be those without normal social status
(b ¼ 0.22, po0.001). As the first block of predictors, demographics explained
6 percent of the variance. Variables from internet connectedness entered into the
equation in the second block, and intensity scope (b ¼ 0.21, po0.001) was found to be
a significant predictor, explaining 5 percent of the variance. This indicates that the
respondents with higher degree of intensity of internet use had more academic
performance decrement. Online gaming is the third block, and the results show that
frequent online game playing (b ¼ 0.10, po0.05) and online gaming history (b ¼ 0.12,
po0.01) were significant predictors, explaining 4 percent of the variance. IAD
symptoms was the strongest predictor (b ¼ 0.37, po0.001) and entered into the
equation in the fourth block, explaining 9 percent of the variance. The hierarchical
regression explained 24 percent of the variance in total.

Discussion
In China, numerous negative media reports about internet addiction have caused
great concern among the public. China was among the earliest to set up clinics, and
even plans to lead the effort by registering internet addiction with the World Health
Organization ( Jiang and Leung, 2012; Macartney, 2008). However, the research on
the internet-dependency group remains scarce. This paper scores as a pioneering study
 Academic performance
Internet
Predictors decrement, b DR 2
addiction
Block 1: demographics
Gender (male ¼ 1) 0.00
Age 0.09
Education level 0.06 15
Social status (normal ¼ 1)a 0.22*** 0.06
Block 2: internet connectedness
History scope 0.01
Task scope 0.02
Site scope (internet café ¼ 1) 0.01
Goal scope 0.06
Activity scope 0.02
Intensity scope 0.21***
Evaluation 0.02
Internet adhesiveness 0.04
Computer interest 0.02 0.05
Block 3: online gaming
Frequent online game playing (yes ¼ 1) 0.10*
Time gaming history 0.12** Table VIII.
Number of friends online 0.08 0.04 Hierarchical regression
Block 4: IAD symptoms 0.37*** 0.09 analysis of the impact of
R2 0.29 demographics, internet
Adjusted R2 0.24 connectedness, online
gaming, and IAD
Notes: N ¼ 594. anormal (at school or at work) ¼ 1, not normal (school dropout, suspending, and symptoms on academic
unemployed) ¼ 0; *po0.05; **po0.01; ***po0.001 performance decrement

focussing on diagnosed internet addicts. Based on the data collected in one of the
earliest and largest internet addiction clinics in Mainland China, this study examined
the interrelationships between internet connectedness, online gaming, IAD symptoms,
and academic performance decrement, as well as identified the predictors of IAD
symptoms and academic performance decrement. Treatment and intervention for
internet addiction among young people should take the findings into consideration.
Research in the field of internet addiction has attempted to delineate between
healthy and problematic use of this medium (Ebeling-Witte et al., 2007). The term
addiction has extended into the psychiatric lexicon that identifies problematic internet
use associated with significant psychological and social impairment (Young, 1998a, b;
Young and Rodgers, 1998). In terms of social well-being, academic performance plays
an important role in young people’s life. According to the results, internet addiction
significantly predicted academic performance decrement. This is particularly relevant
given the excessive internet use among those internet addicts, which can be associated
with educational disruption, with poorer academic assessment and more academic-
related problems.
Consistent with previous research, the findings revealed that males might be more
delinquent in internet use than females (Ma et al., 2011). Although gender was not the
significant predictor for internet addiction, males were in the high-risk category with
higher degree of internet connectedness and online gaming. Moreover, social status
as the occupational variable was significantly associated with internet addiction and
academic performance. Internet addiction caused various academic-related problems
INTR which may lead to school suspending or dropout. Moreover, these respondents who
24,1 could not maintain their normal social status might try excessive internet use to pass
time or for feeling modification. Hence, instead of letting those school dropouts
idling away their time, prevention procedures, regulation, or treatment should target
this high-risk group.
By including internet connectedness scopes, this study drew a more detailed picture
16 of the internet use of the excessive users. Internet connectedness scopes turned out to
be significant predictors for the development of internet addiction and academic
performance decrement. Those who use internet with more goals and higher degree of
internet adhesiveness had more IAD symptoms. In addition, internet café patronage
was found as a significant predictor for internet addiction. However, the overall ICI
index was not found to be significantly related to academic decrement. This result is
consistent with many previous studies that the internet has produced mixed results
regarding young people’s academic performance by providing tremendous benefits as
well as many negative effects (Huang et al., 2009; Jackson et al., 2007; Kim et al., 2009;
Ni et al., 2009; Roschelle et al., 2000). It is reasonable because people may be engaged
with various internet applications and online activities in different ways, and some
can be good for their learning. Thus, the effect of ICI could be moderated or mediated
by another variable. Online game playing was not found to be a significant moderator
in this study, so future studies can be conducted to find out the moderating/mediating
variable(s) based on other samples or regarding other internet activities. Moreover, it is
important to remember that ICI as a multi-dimensional concept includes nine different
scopes of people’s internet use which can have complicated and even conflicting
influences on young people’s academic performance. The findings show that respondents
with higher degree of intensity of internet use had more academic performance
decrement. Therefore, when looking into its effects on academic performance, it is better
to examine its specific scopes rather than treat ICI as a whole.
Online gaming as one of the most popular internet activities was found to have great
influence in the development of internet dependence, and showed negative impact on
the respondents’ academic performance. Online games create compelling, immersive,
and socially rich virtual worlds, therefore the game-playing group showed higher degree
of internet connectedness compared with the non-player group. This study also found
the positive correlation between online gaming and academic impairment. After
indulging in online gaming for long, young people may get immersed within virtual
worlds and gradually neglect their studies. Therefore, the addictive potential of gaming
should be taken into consideration regarding prevention and intervention for internet
addiction. Nevertheless, this study does not suggest that online gaming should be
forbidden in current internet era. As the findings revealed, it was online gaming to the
degree of having IAD symptoms that may lead to negative outcomes, such as academic
performance decrement. Special attention should be paid to this mediating effect.
China is now the country with the largest population of internet users in the world,
which has reached up to 513 million by the end of 2011 (CNNIC, 2012). Among them,
324 million are online game players, who spend quite a considerable amount of time
playing online games (CNNIC, 2012). Online gaming has been widely recognized as
a popular leisure activity and become an ever-increasing part of daily life for young
people in China. Thus, this study calls special attention to the effects on those who play
them. The findings can offer insights for researchers, parents, educators, professionals,
and policy makers, which can be valuable for prevention, treatment, and recovery of
internet addiction.
Limitations and suggestions for future studies Internet
Although this study was among the very few investigations based on the in-patient addiction
internet-dependent respondents and remarkable insights were provided in consistent
with previous research, the findings should be interpreted in the light of the following
limitation. There is no control group in this study, thus it is hard to make comparisons
between internet addicts and normal people. Comparative studies can be conducted
in the future to better illustrate the differences between the internet-dependent 17
group and those individuals whose internet use does not turn out to be problematic.
Future studies may also investigate whether other internet activities can play an
important role in the development of internet addiction like the engagement with
social networking sites. As for the generalizability of results, further research need to
be conducted to compare other social contexts of internet addiction. Comparative
studies can be conducted within Asian area, such as South Korea, Taiwan, and Hong
Kong, where internet addiction has also been brought into public focus. Additionally,
more comparisons can be made between eastern and western worlds, or between
developing and developed countries.

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About the author

Dr Qiaolei Jiang is a Post-Doctoral Fellow at the Nanyang Technological University, Singapore.
She holds a PhD degree in Communication from the Chinese University of Hong Kong.
Her primary research interests include the uses and implications of new communication
technologies, public health, globalization, and popular culture. Dr Jiang has conducted studies
on internet addiction, online gaming community, and mobile phone dependency, among other
topics. She has published papers in journals such as Social Science Computer Review, Mass
Communication and Society, and The International Communication Gazette, and contributed
several book chapters in the volumes such as Principles of Addiction: Comprehensive Addictive
Behaviors and Disorders, and Encyclopedia of China Handbook: Internet in China. Dr Qiaolei
Jiang can be contacted at: jiangqiaolei@gmail.com

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